Remarks by Honourable Vabah Gayflor, Minister of Gender and Development, Republic of Liberia at the Launching of the Commission on Women’s Health in Africa, Commission, Wednesday 14 April, 2010

Your Excellency, President Ellen Johnson-Sirleaf,Honourable Joseph N. Boakai, Vice President,Dr Luis Gomes Sambo, WHO Regional Director for the African Region,Honourable Ministers, Republic of Liberia,Senior Officials of the Government of the Republic of Liberia,Honourable Commissioners of the Commission on Women’s Health,The Special Representative of the United Nations Secretary General to Liberia,Doyen of the Diplomatic Corps,Representatives of Women and Youth Groups,Representatives of the Media,Distinguished Ladies and Gentlemen,

I am greatly honoured to be in this gathering this morning at this important event of the launching of the Commission on Women’s Health. I would further like to express our thanks and appreciation to the World Health Organization for choosing “Women’s Health” as a priority area, especially at time when women are not faring too well in the area of health in our country following our conflict.

Although several key health indicators have improved since the end of the conflict, they still remain poor. This is for a couple of reasons amongst which are; the unequal participation by men in family planning programmes, lack of control over cash for transport to health facilities as well as treatment for women, gender based violence, including rape, wife-beating and the overload of family care work increase the risk of ill health among women than among men.

While we note and commend that infant and under-five mortality rates have fallen sharply since 1999/2000, which are attributable to the end of the conflict, restoration of basic services in some areas and increased immunization; maternal mortality remains staggeringly high and appears to have increased in recent years. Currently estimated at 994 deaths per 100,000 live births (2007), this rate is among the worst in the world. This of course is unfortunate since we are aware that relatively high mortality rates of women are a reflection of unequal gender relations, inequalities in resource distribution, lack of access and availability of drugs and health services in Liberia.

Women and girls are also the main victims of harmful traditional practices affecting their health, often to the point of permanent physical, psychological and emotional damages, even death. Some of these include son preference, nutritional taboos, early marriages, FGM and GBV. Health facilities remain insufficiently equipped to deal with GBV, and also are inaccessible to the majority of survivors.

The years of war further exacerbated the situation of women and girls when they were subjected to vicious and systematic acts of sexual violence which further terrorized Liberians throughout the years of war. According to various assessments done by WHO, in collaboration with the Ministries of Gender and Health (2004, 2005, and 2006), 93% of the 2,828 women and girls interviewed from war-affected communities in ten counties (Lofa, Bong, Nimba, Cape Mount, Bomi, Grand Gedeh, Grand Bassa, Montserrado, Margibi, and Sinoe) said they were subjected to one or multiple acts of abuses and/or sexual violence during the conflict. The assessments targeted women affected by the war. Rape, including gang rape (73% of the total respondents), was the most traumatic experience and often women were assaulted with foreign objects, including flashlight in their vagina or anus. The use of objects led to vesico-vaginal and recto-vaginal fistula representing 15.5 % and 8.5% of the cases respectively.

Similarly, other women of different categories women with disabilities as well as the elderly suffer double discrimination – first as women and second as persons with disabilities; while the elderly face constraints in accessing services and in improving their livelihoods, as well as suffering from old-age related diseases requiring special medical attention. In fact most of the time health facilities are not within easy reach. All of these challenges are further compounded by the high rate of unemployment coupled with low levels of education and training which make women more vulnerable to HIV infections.

We would like to commend the Government, through the Ministry of Health, for the steps taken to address the appalling health situation in the country, through the development of the National Health Policy which started taking a holistic approach to address the health situation in the country with special emphasis on maternal and child health. Besides, the Government has taken the following initiatives to promote health care through legislative and policy framework.

The establishment of Gender Equity and Health Committees within the National Legislative to ensure that women and children issues form a part of the legislative Agenda.

The establishment of a Women Legislative Caucus within the National Legislature to highlight and advocate for the issues of women.

The development of the Poverty Reduction Strategy, which has mainstreamed gender in the four pillars of health, psycho-social, legal and protection.

Liberia’s Beijing + 15 Country Report 2009 and the Liberia Report to the CEDAW Committee.

The Development of a National Action Plan on GBV to respond to and prevent GBV.

The development of a national action plan on Security Council Resolution 1325.

The development of National Gender Policy and Action Plan.

The development of National Health Policy.

The development an Adolescent Reproductive Health Policy.

The issue of gender mainstreaming in the civil service reform processes; and

Setting up of a National HIV/AIDS Commission.

The Ministry of Gender and Development has also been established and is playing a coordination role in the areas of SGBV and implements certain innovative programmes for women and children. These programmes cover welfare and support services, training for employment and income generation, awareness generation and gender sensitization at various levels. These programmes play a supplementary and complementary role to the other general developmental programmes in the sectors of health, education, rural development etc. All these efforts are directed to ensure that women are empowered both economically and socially and thus become equal partners in national development along with men.

As a tribute to this Government, gender is now a part of the national agenda and as such gender has emerged as a cross-cutting issue which has now been recognized fully as a key factor to strengthen a country’s ability to grow, to reduce poverty and improve its standard of living including access to services. The Ministry of Gender and Development was been able to designate and train gender focal points in all the line Ministries and efforts are ongoing in creating an institutional environment which provides equal rights and opportunities for women as well as men. Government’s effort to reduce gender inequalities is translated by the enactment of a National Gender Policy in 2009, which recognizes promoting gender equality as a development strategy for reducing poverty levels among women and men, improving health and living standards and enhancing efficiency of public investments. The attainment of gender equality is not only seen as an end in itself and human rights issue, but as a prerequisite for the achievement of sustainable development.

The Liberia National Gender Policy, 2009 noted “Unequal participation by men in family planning programs, gender-based violence, and overload of work for both productive and family care work, all increase the risk of ill health among women than men. The main health factors contributing to the high level of maternal mortality include the acute shortage of skilled health-workers and extremely high numbers of teenage pregnancies”.

Improving the health of mother and children must be the main focus of the Government of Liberia’s work in Liberia. Women and children remain particularly vulnerable and in need of specialized health services. The National Health Policy and National Health Plan (2007) recognize that equity, social justice and good governance are essential for health and social improvement. The policy states that everyone shall have access to health services, irrespective of social-economic status, origin, gender, and geographical location. So as can be seen, much of the necessary policy frameworks have been established the challenge however is implementation; thus support to all of these initiatives are very critical for the attainment of progress in the area of maternal health.

The National GBV Plan of Action lays out various systematic interventions for the prevention and response to GBV and care support for GBV survivors. The Government Ministries are coordinating the efforts to ensure that the National Health Policy is gender-sensitive and responds to the needs of GBV survivors through developing and implementing guidelines for gender-sensitive health care, including training programs for health care personnel, to foster attitudinal change and provide humanistic health care, with a particular emphasis on women and children in general and GBV survivors in particular.

The Ministry developed and integrated a coordinated-response approach through establishment and strengthening of referral pathways and local networks. Through the referral pathway, timely and quality health, legal and other support will be provided to the SGBV survivors.

The Ministry of Gender considers the larger community of marketing women (an area where women are most often found but could be missed if opportunities are not exploited to reach them) across the country as a potential group and opportunity for providing information on sexual and reproductive health and distribution of contraceptives. Through UN support the Ministry if working on integrating a strong sexual and reproductive health information and services component into the market women in select locations.

However, it must be conceded that gender disparities and gaps still exist. Despite the existence of appropriate legal and policy parameters to eliminate gender disparity, unequal and discriminatory practices continue to persist. The Ministry of Gender and Development with support from other Ministries, civil society and international community is committed to wider dissemination of gender policy and increased access of women to health specifically to sexual and reproductive health information and services. We would like to urge all actors to re exert all efforts in ensuring that the health policy and all other policies for that matter pertaining to women’s health are supported to the later as this is not just a mere women’s issue but a human right for that has very serious implications for a nation.

The Ministry of Gender and Development would one again like to express its thanks and appreciation to the Heads of States in the region for prioritizing this most critical and needy area of women’s health. I am confident that the wealth of experience brought by the Commission will promote South-South Cooperation and contribute significantly in improving the access to health including reduction in maternal deaths by 2015.